Healthcare Provider Details

I. General information

NPI: 1255145421
Provider Name (Legal Business Name): JANAYE ARIELLE MONET CSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2025
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2955 N HWY 97
BEND OR
97703-7559
US

IV. Provider business mailing address

808 NE SAVANNAH DR APT 3
BEND OR
97701-5146
US

V. Phone/Fax

Practice location:
  • Phone: 541-205-9290
  • Fax: 541-610-1692
Mailing address:
  • Phone: 714-733-9476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberA16099
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: